Amy Pinkham

The University of Texas at Dallas | UTD · School of Behavioral and Brain Sciences

Paranoia is a distressing and prevalent symptom in schizophrenia spectrum disorders (SSD). This assessor-masked, randomized parallel group superiority trial investigated the efficacy of virtual reality-based cognitive behavioral therapy (VR-CBT) compared to standard CBT targeting paranoia. A total of 259 participants with SSD and paranoia were rand...

Background and Hypothesis Social cognitive impairments are central to psychosis, including lower severity psychosis-like experiences (PLEs). Nonetheless, progress has been hindered by social cognition’s poorly defined factor structure, as well as limited work examining the specificity of social cognitive impairment to psychosis. The present study e...

To address measurement limitations and challenges within social cognitive research, a group of experts was convened to form the Schizophrenia International Research Society (SIRS) Social Cognition Research Harmonization Group (RHG). The goals of the RHG were twofold: 1) conduct a wide-ranging expert survey to gather nominations for tasks of social...

Background Paranoia is a spectrum of fear-related experiences that spans diagnostic categories and is influenced by social and cognitive factors. The extent to which social media and other types of media use are associated with paranoia remains unclear. Objective We aimed to examine associations between media use and paranoia at the within- and be...

NLP in mental health has been primarily social media focused. Real world practitioners also have high case loads and often domain specific variables, of which modern LLMs lack context. We take a dataset made by recruiting 644 participants, including individuals diagnosed with Bipolar Disorder (BD), Schizophrenia (SZ), and Healthy Controls (HC). Par...

Deficits in facial identity recognition and its association with poor social functioning are well documented in schizophrenia, but none of these studies have assessed the role of the body in these processes. Recent research in healthy populations shows that the body is also an important source of information in identity recognition, and the current...

Neurosciences clinical trials continue to have notoriously high failure rates. Appropriate outcomes selection in early clinical trials is key to maximizing the likelihood of identifying new treatments in psychiatry and neurology. The field lacks good standards for designing outcome strategies, therefore The Outcomes Research Group was formed to dev...

Background and hypothesis Psychotic-like experiences (PLEs) are prevalent in the general population and, because they represent a lower end of the psychosis vulnerability spectrum, may be useful in informing mechanistic understanding. Although it is well-understood that motor signs characterize formal psychotic disorders, the developmental trajecto...

Response times (RTs) to ecological momentary assessment (EMA) items often decrease after repeated EMA administration, but whether this is accompanied by lower response quality requires investigation. We examined the relationship between EMA item RTs and EMA response quality. In one data set, declining response quality was operationalized as decreas...

Neurosciences clinical trials continue to have notoriously high failure rates. Appropriate outcomes selection in early clinical trials is key to maximizing the likelihood of identifying new treatments in psychiatry and neurology. The field lacks good standards for designing outcome strategies, therefore The Outcomes Research Group was formed to dev...

Background and Hypothesis People with serious mental illness (SMI; psychotic and affective disorders with psychosis) are at an increased risk of suicide, yet there is limited research on the correlates of suicide in SMI. Social cognitive impairments are common among people with SMI and several studies have examined social cognition and suicidal ide...

There is a general consensus that personality disorders (PDs) share a general factor (g-PD) overlapping with the general factor of psychopathology (p-factor). The general psychopathology factor is related to many social dysfunctions, but its nature still remains to some extent ambiguous. We posit that hostile attributions may be explanatory for the...

People with schizophrenia-spectrum and bipolar disorders have difficulty accurately estimating their abilities and skills (impaired introspective accuracy [IA]) and tend to over- or underestimate their performance. This discrepancy between self-reported and objective task performance has been identified as a significant predictor of functional impa...

Paranoia is a spectrum of fear-related experiences that spans diagnostic categories and is influenced by the environment. The extent to which traditional and digital media use is associated with paranoia remains unknown. We aimed to examine associations between media use and paranoia at the within-and between-person levels. Participants were 409 in...

Little is known about central nervous system (CNS) responses to emotional stimuli in asthma. Nitric oxide in exhaled breath (FE NO ) is elevated in asthma due to allergic immune processes, but endogenous nitric oxide is also known to modulate CNS activity. We measured fMRI blood oxygen‐dependent (BOLD) brain activation to negative (blood–injection–...

There is a general consensus that personality disorders (PDs) share a general factor (g-PD) overlapping with the general factor of psychopathology (p-factor). The general psychopathology factor is related to many social dysfunctions, but its nature still remains to some extent ambiguous. We posit that hostile attributions may be explanatory for the...

Paranoia, defined as the unfounded belief that others intend to cause harm, negatively affects individuals across the continuum from healthy to pathological. Despite a definition that is explicitly social, paranoia is often studied as an isolated characteristic of the person who is experiencing it. In the current review, we propose that the study o...

Objective Suicide risk among individuals with psychosis is elevated compared to the general population (e.g., higher rates of suicide attempts [SA] and completions, more severe lethality of means). Importantly, suicidal ideation (SI) seems to be more predictive of near-term and lifetime SAs in people with psychosis than in the general population. Y...

Background Autism and psychosis co-occur at elevated rates, with implications for clinical outcomes, functioning, and suicidality. The PANSS-Autism-Severity-Score (PAUSS) is a measure of autism trait severity which has not yet been validated externally or longitudinally. Study Design Participants were derived from the GROUP and SCOPE datasets. Par...

Introduction: The study explored associations between the accuracy of post assessment judgements of cognitive performance with global self-assessments of psychosocial functioning compared to evaluations generated by observers in schizophrenia and bipolar disorder. Methods: An abbreviated cognitive assessment based on the MATRICS Consensus Cognit...

Background: Some research suggests that schizotypal and autistic traits can produce opposing effects on the mentalizing domain of social cognition. Although such findings support a diametrical model proposing that psychotic and autistic traits represent opposite extremes of the social brain continuum, results from recent studies have been more inco...

Models of affect, like the tripartite model, suggest that positive affect (PA) and negative affect (NA) are independent between subjects and negatively correlated within. Correlations may differ in bipolar disorder (BD) and schizophrenia. Using ecological momentary assessment (EMA) and clinical ratings, this secondary analysis evaluated the tripart...

Depression is more prevalent in individuals raised in cold and violent families, which can lead to a lack of connection or frustration in relationships and heightened sensitivity to signs of danger, such as anger on faces. These factors can both exacerbate symptoms of depression. However, research into the links between depressive symptoms and rela...

Depression is more prevalent in individuals raised in cold and violent families, which can lead to a lack of connection or frustration in relationships and heightened sensitivity to signs of danger, such as anger on faces. These factors can both exacerbate symptoms of depression. However, research into the links between depressive symptoms and rela...

Background Residential mobility, or moving to a different city, can negatively affect mental health through stress and disrupted social networks. Emerging literature, however, indicates the potential benefits of residential mobility through increased motivation to develop social ties. Therefore, this study examined how residential mobility affects...

Background Recent studies have begun to examine the role of self-compassion in maintaining and developing paranoia. Although preliminary findings imply that self-compassion may provide resiliency to paranoia, further experimental investigation is warranted to reveal the causal relationships. Methods A sample of college students were randomly assig...

Social cognitive impairments, measured by behavioral tasks, are central to psychopathology; however, the factor structure of social cognition is poorly understood. In addition to concerns related to sample size and reproducibility, few studies have considered higher-order factors of social cognition, which may reveal both substantive and methodolog...

Social cognition is a broad construct encompassing the ways in which individuals perceive, process, and use information about other people. Social cognition involves both lower- and higher-level processes such as emotion recognition and theory of mind, respectively. Social cognitive impairments have been repeatedly demonstrated in schizophrenia spe...

Background: Life engagement represents a holistic concept that encompasses outcomes reflecting life-fulfilment, well-being and participation in valued and meaningful activities, which is recently gaining attention and scientific interest. Despite its conceptual importance and its relevance, life engagement represents a largely unexplored domain in...

Background: Schizophrenia (SZ) and autism spectrum disorders (ASD) are characterized by difficulties in theory of mind (ToM). We examined group differences in performance on a ToM-related test and associations with an estimated IQ. Methods: Participants [N = 1227, SZ (n = 563), ASD (n = 159), and controls (n = 505), 32.2% female] completed the R...

Objective: Self-assessment of cognitive abilities can be an important predictor of clinical outcomes. This study examined impairments in self-assessments of cognitive performance, assessed with traditional neuropsychological assessments and novel virtual reality tests among older persons with and without human immunodeficiency virus (HIV) and mild...

In this study, we examined ethno-racial differences in daily functioning in 66 non-Latinx White participants, 83 non-Latinx Black participants, and 60 Latinx participants ( N = 209) diagnosed with serious mental illnesses, and the extent to which individual socioeconomic status (SES), neighborhood SES, and symptom severity accounted for observed di...

Introduction People with schizophrenia-spectrum disorders (SSDs) and bipolar disorders (BDs) experience difficulty with social cognition, or the mental processes that underlie social interactions, but determinants of social cognitive impairment are still under investigation. Research suggests that poor sleep quality is related to reduced social cog...

Objective: Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia. Method: Data from clinical, neurocognitive, and soc...

While considerable emphasis has been put on investigating the mechanisms that drive reduced social connection in patients with schizophrenia (SCZ), recent studies have increasingly focused on the issue of loneliness in SCZ. As both social cognitive bias and self-reported empathy predict loneliness in non-clinical populations, the current study aims...

Background: Autism and psychosis co-occur at elevated rates, with implications for clinical outcomes, functioning, and suicidality. The PANSS-Autism-Severity-Score (PAUSS) is a measure of autism trait severity which has not yet been validated externally or longitudinally. Study Design: Participants were derived from the GROUP and SCOPE datasets. Pa...

Introduction: Individuals with schizophrenia are at increased risk for suicide, and the Demoralization Hypothesis states that non-delusional awareness of one's social, cognitive, or occupational deterioration elicits depression and hopelessness. Both depression and hopelessness are established risk factors for suicide and are features of schizophr...

Introduction: Many people with schizophrenia report low levels of negative affect (NA), which may reflect biases in emotion processing. In the general population there is an inverse correlation between positive affect (PA) and NA. It is possible that this relationship is different among people with schizophrenia. This study aims to understand the...

Background: Childhood trauma is associated with a variety of negative outcomes in psychosis, but it is unclear clear if childhood trauma affects day-to-day social experiences. We aimed to examine the association between childhood trauma and functional and structural characteristics of real-world social relationships in psychosis. Methods: Partic...

Objective: Introspective Accuracy (IA) is a metacognitive construct that refers to alignment of self-generated accuracy judgments, confidence, and objective information regarding performance. IA not only refers to accuracy and confidence during tasks, but also predicts functional outcomes. The consistency and magnitude of IA deficits suggest a sus...

We unfortunately need to make an update to our published study protocol that describes a significant change in the design of the study. The Committee on Health Research Ethics of the Capital Region Denmark recently rejected the approval of changing the primary outcome in the trial, on the invariable grounds that the trial has already commenced. It...

Introduction: Mood states have been reported to manifest a cross-sectional correlation with self-assessment accuracy across functional domains and psychiatric conditions. Ecological momentary assessment (EMA) provides a strategy to examine the momentary course and correlates of mood states. This study tested the association of moods assessed longi...

We unfortunately need to make an update to our published study protocol that describes a significant change in the design of the study. The Committee on Health Research Ethics of the Capital Region Denmark recently rejected the approval of changing the primary outcome in the trial, on the invariable grounds that the trial has already commenced. It...

Background Avolition is associated cross-diagnostically with extensive functional impairment. Participants with schizophrenia and bipolar disorder (BD) engage in fewer productive activities than healthy controls, with more sedentary activities such as sitting. We examined the temporal variability in activities of participants with schizophrenia and...

Aim People with serious mental illness (SMI) are at an increased risk for suicide. Social approach and avoidance motivations are linked to social functioning, and social isolation is a risk factor for suicide. This study uses ecological momentary assessment (EMA) to understand social approach and avoidance motivations in relation to symptoms and su...

Participants with schizophrenia (SCZ) and bipolar disorder (BD) have challenges in self-evaluation of their cognitive and functional abilities, referred to as introspective accuracy (IA). Although psychotic symptoms are commonly found to be uncorrelated with cognitive performance, many models of the development of delusions focus on failures in sel...

Among individuals with schizophrenia, paranoia has been linked to increased resting cerebral blood flow (CBF) in amygdala, suggesting that amygdala hyperactivity may be a mechanism for paranoid ideation. The present study tested this possible mechanism by assessing whether experimentally inducing paranoia in non-clinical, healthy participants resul...

COVID-19 patients and survivors quite often experience depressive symptoms, which can increase risk for lower immune system response and poorer recovery. Vulnerability to depressive symptoms may be elevated in those patients who have the most severe COVID-19 course of illness, that is, patients who require supplementary oxygen therapy or even intub...

Background Emotion recognition deficits are linked with social dysfunction in psychosis, as is inaccurate self-assessment of emotion recognition abilities. However, little is known about the link between ER and real-time social appraisals and behavior. Methods In 136 people with psychotic disorders or affective disorder with psychosis we administe...

There is considerable variability in neurocognitive functioning within schizophrenia-spectrum disorders, and neurocognitive performance ranges from severe global impairment to normative performance. Few investigations of neurocognitive clusters have considered the degree to which deterioration relative to premorbid neurocognitive abilities is relat...

Background Paranoid ideation is a core feature of psychosis and is associated with impaired social functioning. Severity of paranoia can fluctuate across time as symptoms wax and wane; however, no study has systematically investigated how this intra-individual variability in paranoia may relate to social impairments and social functioning. Methods...

Background Schizophrenia spectrum disorders cause suffering for patients, relatives, and the surrounding society. Paranoid ideations, encompassing ideas of social reference and manifest persecutory delusions, are among the most frequent symptoms in this population and a cause of significant distress. Recent meta-analyses of cognitive behavioral the...

It is critical to intervene early in the mild cognitive impairment (MCI) stage of the Alzheimer's disease trajectory, but traditional cognitive testing methods are costly, burdensome, and difficult to access. We examined adherence and validity data to a 30-day self-administered ecological momentary cognitive testing protocol among a sample of older...

Aims: People with severe mental illnesses have impairments in their perceptions of their abilities (introspective accuracy [IA]) and tend to be overconfident while completing tasks. One unexplored variable that may impact IA and confidence in this group is sleep quality. Sleep quality is associated with variables related to IA and confidence, inclu...

Background Schizophrenia Spectrum disorders cause suffering for patients, relatives, and the surrounding society. Paranoid ideations, encompassing ideas of social reference and manifest persecutory delusions, are among the most frequent symptoms in this population and a cause of significant distress. Recent meta-analyses of Cognitive Behavioral The...

Many social cognitive assessments that were developed specifically for use in clinical populations are now being widely used in undergraduate populations, either to provide a comparison for clinical groups or to explore performance across the continuum from healthy to subclinical populations. However, the appropriateness of using these assessments...

Milestone achievements are reduced in people with schizophrenia and are lower in comparison to people with bipolar disorder. However, it is not clear what the implications are for engagement in momentary activities based on milestone achievements. Further, some recent research has suggested that psychotic symptoms are associated with challenges in...

Background: Previous weekly sampling studies found that persistent sad moods are associated with disability in bipolar illness. However, those data were collected retrospectively. We examined the momentary quality of activities (productive, unproductive, and passive recreation) in an ecological momentary assessment (EMA) study and related sadness...

Background Inaccurate self-assessment of performance is common among people with serious mental illness, and it is associated with poor functional outcomes independent from ability. However, the temporal interdependencies between judgments of performance, confidence in accuracy, and feedback about performance are not well understood. Methods We ev...

Autistic adults and those with schizophrenia (SCZ) demonstrate similar levels of reduced social cognitive performance at the group level, but it is unclear whether these patterns are relatively consistent or highly variable within and between the two conditions. Seventy‐two adults with SCZ (52 male, M age = 28.2 years) and 94 with diagnoses on the...

The aim of the present study was to develop an abbreviated social cognition (SC) battery for individuals with schizophrenia spectrum disorders (SSD) to reduce the heterogeneity of and increase the frequency of assessment of SC impairment. To this end, the present study utilized Item Response Theory to develop brief versions of SC tasks administered...

Objectives Schizophrenia participants generate self-reports of their competencies that differ from objective information. They may base their reports on momentary moods or experiences rather than objective data. Theories of delusion formation implicate overconfidence during self-assessment as a cause. Methods Ecological momentary assessment (EMA)...

While considerable emphasis has been put on investigating the mechanisms that drive reduced social connection in patients with schizophrenia (SCZ), recent studies have increasingly focused on the issue of loneliness in SCZ. Both social cognitive bias and self-reported empathy predict loneliness in non-clinical populations, the current study, theref...

Background Loneliness is a concern for patients with schizophrenia (SCZ). However, the correlates of loneliness in SCZ are unclear; thus, the aim of the study is to investigate neuro- and social cognitive (SC) mechanisms associated with loneliness in SCZ. Methods Data for the study were pooled from two cross-national samples (Poland/USA) and inclu...